September is Suicide Awareness Month and Sept. 10 World Suicide Prevention Day
It’s important for all to understand this serious and preventable public health crisis in order to better care for ourselves and for our most vulnerable patient populations. Here are some facts about suicide in our state (Suicide Prevention | Washington State Department of Health):
Men in Washington: die by suicide at a substantially higher rate than women. The age adjusted suicide rate for men (25.0 per 100,000) is more than three times higher than that for women (7.1 per 100,000) for the period 2018-2023.
Age: The highest suicide rates are observed among adults aged 45-54 and 55-64, followed closely by older adults aged 75-84 and 85+.
Race/Ethnicity: American Indian/Alaska Native communities have the highest suicide rate among all racial and ethnic groups in Washington, underscoring the urgent need for culturally appropriate interventions.
Geographic Distribution: While counties with larger populations have the highest number of suicide deaths, rural areas often face unique challenges and higher rates when population size is considered.
Methods: Firearms are the most common means of suicide in Washington, accounting for nearly half of all deaths by suicide.
Resources available TO YOU as a provider:
1) For immediate care: Call or text 988 or chat online at (https://988lifeline.org/chat/). The 988 Suicide and Crisis Lifeline provides acute support for those with a mental health crisis. The 988 Lifeline provides support in Englis, Spanish, and American Sign Language along with interpretation services in 240 languages and dialects.
2) Wellspring Early Assistance Program (EAP): 1-800-553-7798, www.wellspringeap.org, username Providence St. Peter Hospital
Below are policies and resources available FOR CLINICAL PRACTICE/FOR OUR PATIENTS:
1) Suicide Risk Documentation (C-SSRS) (providence.org) –
a. Recommend all providers complete this learning activity (requires access to HealthStream) for background on C-SSRS: PROV: Care of Patients at Risk for Suicide – Direct Caregiver (https://www.healthstream.com/HSAPP/CourseDetails?courseInstanceId=430131fe-44fe-4893-9efd-4ae7b2f4b441&courseDetailsTab=LearningActivities)
i. Providers should verify that the C-SSRS screening and assessment have been completed upon admission and as needed anytime SI/SA is endorsed.
ii. If the C-SSRS is completed during the Emergency Department admission it will count as the initial inpatient suicide screen.
iii. The C-SSRS Daily/Shift screen will be completed at change of shift for patients that are low, medium or high risk and on an as needed basis during hospitalization for patients that exhibit suicidal behaviors or suicidal ideation.
iv. If at any time during hospitalization a patient verbalized SI and engage in SA gestures, the patient is immediately placed on 1:1 monitoring until further assessment by Mental Health Professional (MHP), Behavioral Health Practitioner/Provider.
Length of Stay
August appears to have been a better month at both ministries, but the work continues through the end of the year to build and maintain momentum. While numbers don’t finalize until closer to the 15th of the month, LOS at St. Peter Hospital is coming in at 6.33 for August, the best month of 2024 for St. Peter. For Centralia Hospital, LOS is close to 4.59 for the month pending data through the 15th. While celebrating these successes, there is still much work to do to close out the year.
Consult and Transfer Documentation
Please be sure drop a note! When consulting on, particularly when accepting (or declining) transferring patients, please be sure to document your professional opinion, acceptance (or otherwise) and any tentative plans for the patient. I received kudos for Dr. Cruz at St. Peter who documented in his note his opinion and recommendations for a potential transfer which allowed the team at Providence Centralia to keep the patient there and to collaborate with the family on recommendations. Thanks Dr. Cruz for your thorough documentation!
